One of medicine's great challenges is how to persuade patients to take the drugs they are prescribed. More than 900 million prescriptions for drugs are written in the UK each year but around 30 per cent are never taken – either because the prescription is not dispensed or because patients don't take the medicines when they get them home.
It may appear surprising that people will go to the trouble of making an appointment with a doctor, visiting the surgery, getting a diagnosis and a prescription, and then choose not to follow it.
The reasons are many. The drugs may be painful to take, if by injection. There may be side effects. Remembering which drugs to take and when to take them can be tedious and difficult, if there are several and the patient is elderly. And the benefits may make themselves felt only slowly, if at all.
Lack of compliance is a major problem causing detriment to patients' health and huge losses to the NHS. The development of a microchip that can be implanted under the skin to deliver drugs in timed, measured doses in response to wireless commands therefore represents a significant advance. It was hailed by scientists yesterday as heralding a new era in telemedicine.
It is no accident that the first test of the device was in seven women with osteoporosis who had been prescribed the drug teriparatide, normally given by injection. Improvement with osteoporosis is slow and women treated for the condition often stop giving themselves the daily jabs, which are unpleasant, because they cannot see progress. An automated, painless delivery system that the women could forget about was a clear bonus for them.
Cancer, heart disease and multiple sclerosis are other therapeutic areas where it could be used. Diabetics could benefit from a sensor being developed to monitor blood glucose levels that could one day be combined with the microchip to deliver insulin.
Ultimately the US manufacturer hopes to develop more complex devices with as many as 400 compartments which could be left in place for more than a year.
Patients would need reassurance about safety and the protection provided against inadvertent overdose in the event of failure.
One area it does not mention is mental health. Yet this is the area of medicine with the greatest compliance problems of all. People diagnosed with schizophrenia, for example, may resist the monthly injection that keeps their illness in check. An implantable device that delivered drugs remotely at the psychiatrist's command might save some schizophrenic patients from losing their minds. But the Orwellian implications of such a move would be certain to be challenged on civil liberty grounds.